Incidence of Concussion in Men's Super League, Championship, and Academy Rugby League Matches Between 2016 and 2022

Objectives:
To quantify the incidence of concussion and compare between playing level in male rugby league.
Design:
Retrospective cohort
Methods:
Between 2016 and 2022, medically diagnosed concussions in Super League, Championship, and Academy competitions were reported to the Rugby Football League via club medical staff. Anonymised data were analysed using generalized linear mixed-effects models by season, month, and between competitions.
Results:
Overall, 1,403 concussions were identified from 104,209 player-match hours. Concussion incidence for Super League, Championship, and Academy was 15.5, 10.5, and 14.3 per 1,000 player-match hours, respectively. Championship concussion incidence was significantly lower than the Super League (p<0.001) and Academy (p<0.001). No significant differences were identified between year for Super League (range: 13.3 to 18.8 per 1,000 player-match hours) and Championship (range: 8.4 to 12.1 per 1,000 player-match hours). In Academy (range: 9.6 to 20.5 per 1,000 player-match hours), concussion incidence was significantly greater in 2021 compared to earlier years (2016, p=0.01 and 2017, p=0.03). No significant differences were identified between months for any competition.
Conclusions:
The incidence of concussion is greater in Super League and Academy compared to the Championship. Academy concussion incidence has increased over time. Different factors between and within competitions, such as changes to medical standards and knowledge, could have influenced the identification and diagnosis of concussion.